Chronic Inflammation and Chronic Diseases

Some of the most popular New Year’s resolutions every year are:
*Lose Weight
*Get in Shape
*Reduce Stress
*Get Healthier
*Win the Lottery

The Secret of Vigor can help you with 4 out of 5 of the most popular resolution goals, so I’ll be posting excerpts from the book for the next several weeks – so please stay tuned for each installment.

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Chronic Inflammation and Chronic Diseases
Chronic inflammation is not only a problem that affects the way you feel on a daily basis or the level of vigor you experience. It also contributes to the development of serious health conditions, including four that we will briefly discuss in this section: heart disease, cancer, obesity, and diabetes.

Heart Disease
Researchers probably know the most about the adverse effects of chronic inflammation when it comes to heart disease. Until about ten years ago, most cardiologists and other health experts believed that heart disease was a simple “plumbing” problem, with too much cholesterol being the culprit that clogged up blood vessels and led to heart attacks.

Unfortunately, the cause of heart attacks was later determined to be a little more complicated when population studies showed that at least half of all heart attacks occurred in people with perfectly normal cholesterol levels. What scientists know now is that oxidative damage (by free radicals) is what allows cholesterol to become “sticky” in the first place and to start plugging blood-vessel linings with plaque deposits.

Chronic inflammation, therefore, seems to be the “trigger” that causes those deposits to rupture and create a blockage in the heart, leading to a heart attack. The degree of chronic inflammation throughout the body can be measured by blood levels of a protein called “C-reactive protein” (CRP).

CRP is produced in the liver, with levels rising in direct proportion to inflammatory signals in the body. During times of active infection (acute inflammation), CRP levels may rise by a factor of one thousand to fifty thousand in response to the increased production of cytokines, such as IL-6, from macrophages. A CRP value of 3.0 mg/L is associated with a tripling of heart-attack risk, while people with very low CRP levels (below 0.5 mg/L) rarely have any sign of inflammatory heart disease. You may have to push for it, but you can have your CRP levels tested the next time you’re in the doctor’s office.

Cancer
For more than one hundred years, researchers have known that cancerous tumors tend to arise and cluster at sites of chronic inflammation. Stated another way, sites of chronic inflammation seem to attract and promote the growth of cancer. Part of this effect might have to do with the fact that sites with more inflammation will also have more oxidative free-radical damage—so DNA damage and subsequent “mistakes” during repair may result in more mutations and a higher chance for cancer development. Another factor may be that a higher concentration of inflammatory cytokines attracts a greater number of immune cells, which “think” they’re being called to the site of an infection and thus create even more damage as they try to “kill” a nonexistent pathogen. So here is evidence of the ultimate conundrum: Your immune cells, which normally protect you against cancer, may actually be co-opted by excessive inflammatory signals into stimulating further cancer growth.

Obesity and Diabetes
Obesity is defined as an excess of adipose (fat) tissue, with adipose tissue producing a range of inflammatory cytokines (adipokines, adiponectin, leptin, resistin, TNF-alpha, IL-6, IL-1, and many others). Adiponectin and leptin are the most abundant adipokines and are considered key signaling compounds in regulating inflammation within fat cells and throughout the body.

Adiponectin levels are markedly decreased in obesity, diabetes, and heart disease and are thought to contribute direct anti-inflammatory effects. Leptin, on the other hand, is considered a highly proinflammatory and proatherogenic cytokine that is associated with elevated body fat levels and reduced insulin sensitivity. The ratio between adiponectin and leptin has been proposed by some researchers as a useful index of heart-disease risk in patients with obesity and diabetes. Leptin acts directly on the hypothalamus region of the brain to regulate food intake and energy expenditure. Leptin helps the body tell the brain that the body is satiated and that enough fat is stored. The amount of leptin produced is proportional to the amount of body fat stored, so when you lose body fat, your leptin levels fall and your hunger increases to drive you to eat to “replace” the lost fat. On the other hand, adiponectin increases fat oxidation and improves the activity of insulin to regulate blood-sugar levels. Through cytokines/adipokines, fat tissue can be directly influenced by the overall inflammatory state of the body, but through the action of cytokines/adipokines on the brain, fat tissue can also influence inflammation throughout the entire body.

Aside from the adipokine signaling mentioned above, another important source of chronic inflammation associated with abdominal obesity is the constant activation of the innate immune system. As they grow, changes in cell-surface proteins on adipose tissue can allow swollen abdominal fat cells to resemble bacterial cells or tumor cells in certain ways. This effect attracts cells from the innate immune system (macrophages, neutrophils, and NK cells), which attempt to destroy the “tumor” (your own fat cells) with their normal bursts of free radicals and cytokines.

Unfortunately, rather than killing off your fat (if only it were that simple!), this immune system attack merely damages your fat cells, which sets off the expected normal cycle of injury/inflammation/repair that any of your body cells would undergo. The really bad news is that the end result is yet a higher level of inflammation and oxidation—and a growth of fat stores through a variety of metabolic signals.